Preterm Labor Associated with Cervical Cerclage Infected by Morganella Morganii: A Case Report

Author(s): Christina Pagkaki, Panagiotis Tsikouras, Nektaria Kritsotaki, Sotiris Andreou, Sonia Kotanidou, Nikolaos Nikolettos

Backround:

Cervical cerclage (CC) is one of the limited effective interventions currently available to prevent preterm resulting from cervical insufficiency. One of the possible complications of cervical cerclage is infection of the suture. Morganella Morganii is considered as an uncommon,opportunistic pathogen that mainly causes postoperative wound and urinary tract infections and rarely involves obstetrical pathology.

Case presentation:

We report a 37-year-old, G2P1 woman, with a history of a previous preterm birth due to cervical insufficiency, who underwent cervical cerclage placement at 20 weeks of gestation. She presented to the maternity department at 35+4weeks of gestation with vaginal discharge and uterine contractions. The cerclage was removed, and she gave birth vaginally the next day. A laceration of the cervix occurred during the labor and the neonate was admitted two days afterwards to the neonatal ICU because of apneas, caused by an infection. The culture of the cervical cerclage suture yielded multiresistant Morganella Morganii.

Conclusions:

Cervical cerclage-related infections due to Morganella morganii are rare but clinically relevant. This case underlines that early diagnosis and timely removal of cerclage,tailored antibiotic treatment may improve maternal and neonatal conditions in such cases. More studies are needed to determine the epidemiology and personalized management of these patients.